What happens when all the hospitals are overwhelmed? What’s the protocol?

[MissMessy12]

Just that really. The reality of the severity has sunk in. What happens when hospitals cannot admit anymore patients, supplies are sparse and medical professionals can no longer cope with demand? What’s the protocol? Will people really be left to die?

I keep feeling so sad for doctors as their stress levels must be so high when patients can’t always get adequate help now.
Our area has been relatively ok but I’ve seen we now have many Covid cases in our local hospital too and that Covid patients from Kent are being moved to the South West.

I hope everyone can be as careful as possible and that vaccines soon come.

@FOJN

Will people really be left to die?

Yes I'm afraid that is likely to be the reality. Ambulances won't be available to attend to people. Social media will be full of distressing stories about people dying in awful circumstances. Many will be alone, in pain and frightened and there simply will not be anyone available to alleviate their symptoms or comfort them.

Still a friend managed to mix with 4 households in a tier 2 area over Christmas, with two of the household having travelled for a few days stay from tier 4. It must have been lovely. I'll try not to judge and show some humanity! Shame there'll be fuck all humanity for those left to a shitty death.

This happened to my nan. Suspected stroke, couldnt move her off the floor. Spent 12 hours lying on the floor, blood seeping from her mouth, unable to respond. Paramedic arrived first. An ambulance came after 14 hours, they had been stacked up at the local hospital unable to attend anything. She was stop of the list apparently.

Died in hospital less than a day later.

@kimmy121 - so sorry for your family and your poor nan

I'm going to sound absolutely vile saying this.

But I hope they don't prioritise pissed/ or beaten up people with greater chance of survival at parties tonight over elderly patients with COVID.

But yes they'll prioritise.

@TheKeatingFive

Who’s minimising? I’m just stating what’s likely to happen.

Maybe not minimising but missing the point. Palliative care is for people where there is no more treatment available because their condition cannot be reversed. Many conditions are, now, reversible or at least not death sentences, if the medical treatment is given straightway. Again sepsis is a curable condition if caught in time. Time is a major factor in most emergency situations. Time won't be available if there are no ambulances no room in A & E etc. I'm going to keep saying this to try and ram the point home ...what happens to a five year old child who has sepsis and no paramedics/ doctors available to assess and give IV antibiotics?

It's not uncommon for patients to be offered palliative care only when that is in their best interests. To quote an ITU colleague, "CPR is not a treatment for normal dying."

It is - fortunately - rare for patients to be offered palliative care only when intervention would be in their best interests, but the resources are not available.

We are going to see the latter.

Kimmy121 - I'm sorry for the loss, and for the manner of it.

kimmy I'm sorry, that is really shocking

kimmy121

I am so sorry for your loss. There is nothing anyone can say to make you feel better about that situation. I'm sending you a big virtual hug.

Who will administer the palliative care? Kimmy’s nan didn’t get it, at least not in a timely way. It’s very naive to think there are the resources to offer even this, even if the medical staff were not themselves becoming sick.

WiseUpJanetWeiss

You are right. I wish the penny would drop for people. I feel sick at the anguish some people are going to experience in the coming weeks.

And backed up ambulances isn’t even unusual. It’s a problem every winter.

It's awful.
Fine an hour before she became ill.

What makes it worse I have friends in that hospital, I know how busy and overwhelmed they are. Poor nurses.

My grandfather got out of the same hospital tonight (small mercies) after being taken in 2 days after she died. Hes not well but hes so much better.
Home to an empty house on NYE though

It’s fine. Just keep on sending your kids to school. All fine. Nothing to see here.
I don’t understand how we have got it all so wrong. It’s such a shit show. I can not even put in to words how much I hate this lying, pathetic, lazy, uncaring government.

In the first wave in April care homes rang ambulance in to take elderly into hospital but often told keep them in care home, no Oxygen do they died. I have heard one hospital yesterday in London was full so was diverting emergencies to another hospital and Oxygen was also in low supply. I heard this on Sky news on 30th. I think we have a tough 6-8 weeks before vaccines kick in. ATM on 31st about 57,000 new cases. In 2-3 weeks some of those people will be getting really ill and need hospitalisation. Deaths on 31st was very high over 900 again. 2-3 weeks ago we were on 20,000 new cases a day. In 2-3 weeks deaths could be up to 2,000 as day. NHS staff are exhausted and in many hospitals ITU staff are having to do 1 staff to up to 3 patients. In UK it is usually 1-1. In Italy I know it is usually 1-2. Lots of staff working longer shifts too. I hope they don't burn out. I am simply not going out except in garden. Not healthy, but better than risking Covid. Thank goodness for online shopping.

@kimmy121 - I'm so sorry. Your poor nan. Thinking of you and her. Nobody should have to die like that.

OP - you asked for a protocol. Here's one from one hospital, albeit US

www.huntingtonhospital.org/our-services/emergency-trauma/hospital-preparedness-covid-19-information/care-during-a-public-health-emergency/

There's a patient information leaflet you can click through to too. But basically what it amounts to is a committee gets the medical information on the patients, without any information about race, religion, insurance status etc, and decides who gets a ventilator. The goal is to save the most lives, rather than provide the best care for the individual.

Unbelievably grim for all involved.